our Health
DR GITA MATHAI
Rogue, fraud, charlatan. Words we often use to describe the roadside palmist. Can anyone say what the creases, lines and stars etched on our palms mean? Or if they do mean anything at all?
Some people, it seems, can say much about your life by “reading” your palm.
Welcome to the world of medical palmistry, a branch of science based on documented and proven scientific observations.
A detailed examination of the palm does provide valuable clues to a person’s medical history, lifestyle, diseases and life expectancy. Palms and fingers have characteristic creases, whorls, arches and loops. These are unique in each individual and never identical, even in twins. One of the oldest biometric methods of establishing positive identity is by using fingerprints.
“Palmar creases” form in an unborn baby as it holds its hands tightly clenched during the 12th week. Normally this forms three palmar creases or lines. Any physical, medical or drug-induced injury to the foetus during the first three months is reflected permanently as abnormal palmar creases. This can be picked up on ultrasound examination after the 12th week. If the creases are abnormal, the foetus should be closely monitored for associated abnormalities in the kidney, heart and other organs.
Sometimes the upper two lines fuse to form a single palmar crease or simian line that stretches across the open palm. A single palmar crease can be present in one out of 30 apparently normal people. It is more common in males and is usually present only on one hand. One or both parents of these children may have the abnormal crease on one hand. This is a minor aberration and warrants monitoring as these children may reveal mild abnormalities in other organs in later life. It is also associated with certain chromosomal anomalies, the most common of which is Down’s Syndrome (Trisomy 21).
Not all abnormal palmar creases are hereditary or genetic. Alcoholic women who continue to drink during pregnancy can produce children with “foetal alcohol syndrome” and a single palmar crease.
People with mental illnesses have more open loops and fewer whorls on their finger tips. Those prone to chronic diseases like leprosy and tuberculosis also tend to have only two lines on the palm, with the abnormal line just above the thumb.
Normally, a person has 10 fingers and toes. In one in 1,000 births, there may be extra digits, separate, complete, incomplete or fused. These defects can be associated with other internal congenital malformations, and so a detailed examination must be done for any affected newborn.
Marfans syndrome is a genetic disorder in which the person has “arachnodactyly” or abnormally long fingers like spider legs. This can be diagnosed before birth through ultrasound.
Congenital hypothyroidism, certain renal diseases and some forms of dwarfism are linked with a “tripartiate” hand — where the index, middle and ring fingers are the same length.
Cigarette smokers, people suffering from chronic respiratory ailments, and those with congenital heart disease may have blue nails. Some lung diseases like bronchiectasis, and chronic intestinal diseases may bend the nail like a convex parrot beak, a condition called “clubbing”. Jaundice causes the skin of the palms to turn yellow. Carotenemia produces a similar appearance. It is a harmless condition and is caused by an excess consumption of yellow carotene containing fruits and vegetables.
Hormone levels in the uterus also influences finger length. A person (irrespective of sex) with the index finger shorter than the ring finger will have had more testosterone (male hormone) while in the womb, and a person with an index finger longer than the ring finger will have had more eostrogen (female hormone). Professional women, especially women scientists, tend to have higher levels of testosterone vis-a-vis their oestrogen level, making their brains closer to those of men in general. The converse is true with men working in the fine arts and social sciences.
The position in which we hold our palms is a reflection of the body mass index or BMI (weight in kilogram divided by height in metre squared). A BMI more than 30 is diagnostic of obesity. Such people tend to hold their hands with the thumbs facing backwards as they stand. Overweight people with a BMI between 25 and 30 hold their arms with the thumb facing sideways. People of normal weight with a BMI between 20 and 25 stand with their palms facing forwards.
So, remember, your palms will reveal a lot about your health, but only if you go to a medical palmist.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Monday, March 29, 2010
Saturday, March 20, 2010
Can't get the words out
Stutter and stammer
Your Health
DR GITA MATHAI
“Honey should be applied to a baby’s tongue soon after birth. The child then goes on to develop sweet speech with no stammering.”
This was the practice a century ago. Medically, the honey did nothing to prevent stammering. But if it was contaminated with bacteria, it did cause fatal botulinium poisoning with flaccid paralysis in a significant percentage of children.
Around 10 million people in India stammer. The speech disorder affects 3-5 per cent of children, of which one per cent continues to stammer into adult life. About 80 per cent of the affected children are boys, and first-born males are more likely to be affected. Around 65 per cent of them have a family history of stammering. In most cases, it is the father who stammers or has rapid staccato speech.
Speech is a complex process. A person decides what he or she wants to say, and electro chemical signals are triggered in the brain’s speech area. These signals have to reach the muscle groups in the pharynx, larynx and tongue. If the speed of the thought and the release of the chemicals are not perfectly co-ordinated, stammering occurs. Words or syllables are repeated or prolonged, speech suddenly stops and no sound emerges. The speech becomes blocked in spasms, resulting in repetitive sounds or no sound at all. Even in normal people, emotions can trigger such a condition. In those who stammer, anxiety anticipation of stammering, and embarrassment can trigger tics and spasms of the facial muscles as well.
Children start to stammer before the age of five. It may first become evident when they start school. Many recover spontaneously, while others require treatment. If the stammering continues beyond the age of seven, it is likely to persist into adult life.
Many famous people like Winston Churchill stammered. It didn’t prevent them from scaling great heights. In most cases, however, the sufferer fails to achieve his or her potential. Such people fail in job interviews and viva voce presentations, as stress worsens the stammer. Society often pokes fun at these individuals. In films too comedians are often shown to stammer. As a result, these otherwise intelligent and sensitive people become withdrawn and isolated.
When in contact with a person who stammers:
• Try not to show your embarrassment or look away. Do not reassure them just wait patiently and they will complete what they want to say
• Do not try to complete their sentences for them
• Maintain eye contact
• Many of those who stammer find answering the phone an ordeal. So if the phone rings and there is silence, wait till the person is able to speak.
Stammering is not due to tongue-tie, so surgery does not help. Since it is aggravated by stress, and the affected individuals appear distressed, antiaxiolytic medications like alpraxolam and valium, tranquillisers and antidepressants were initially tried. But they were not very useful. In short, there is no magic pill to cure stammering.
If a child’s stammer lasts more than six months, causes psychological problems in school, or continues beyond the age of five, it needs to be evaluated.
Children cannot voluntarily control stammering. Ridicule, asking him or her to speak slowly, or forcing him or her to repeat the words wont help. The only way parents can help is by providing a relaxed and supportive environment where the child is allowed to speak without feeling self-conscious.
Speech therapists can work with people who stammer, and by using a variety of techniques, can improve the speech. They can also help improve communication skills and create self awareness and confidence. Newer auditory feedback devices and computer assisted speech training can also be tried out. Many people do not have access to speech therapists and are forced to handle their child’s stammering as best they can.
A person may stammer while talking but not while singing. Asking him or her to formulate thoughts in the mind and then speak in a singsong way often helps. Speaking slowly, syllable by syllable instead of complete words, gets rid of the repetitive “th th th” sounds. Asking the person to follow the speech of the therapist or parent also helps. Sometimes using a gesture as the stammer sets in takes the concentration away from the speech and the stammer disappears.
Universal tips
• Sing the words
• Visualise the words in your head first
• Take a deep breath before speaking
• Speak slowly and break up the words into smaller components
• Speaking loudly or in a whisper makes stammering less obvious
If your child stammers, encourage him or her to do physical activity. This gives confidence which helps the anxiety and depression caused by stammering. Yoga calms the mind and corrects faulty breathing. It also improves speech in those who stammer.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Your Health
DR GITA MATHAI
“Honey should be applied to a baby’s tongue soon after birth. The child then goes on to develop sweet speech with no stammering.”
This was the practice a century ago. Medically, the honey did nothing to prevent stammering. But if it was contaminated with bacteria, it did cause fatal botulinium poisoning with flaccid paralysis in a significant percentage of children.
Around 10 million people in India stammer. The speech disorder affects 3-5 per cent of children, of which one per cent continues to stammer into adult life. About 80 per cent of the affected children are boys, and first-born males are more likely to be affected. Around 65 per cent of them have a family history of stammering. In most cases, it is the father who stammers or has rapid staccato speech.
Speech is a complex process. A person decides what he or she wants to say, and electro chemical signals are triggered in the brain’s speech area. These signals have to reach the muscle groups in the pharynx, larynx and tongue. If the speed of the thought and the release of the chemicals are not perfectly co-ordinated, stammering occurs. Words or syllables are repeated or prolonged, speech suddenly stops and no sound emerges. The speech becomes blocked in spasms, resulting in repetitive sounds or no sound at all. Even in normal people, emotions can trigger such a condition. In those who stammer, anxiety anticipation of stammering, and embarrassment can trigger tics and spasms of the facial muscles as well.
Children start to stammer before the age of five. It may first become evident when they start school. Many recover spontaneously, while others require treatment. If the stammering continues beyond the age of seven, it is likely to persist into adult life.
Many famous people like Winston Churchill stammered. It didn’t prevent them from scaling great heights. In most cases, however, the sufferer fails to achieve his or her potential. Such people fail in job interviews and viva voce presentations, as stress worsens the stammer. Society often pokes fun at these individuals. In films too comedians are often shown to stammer. As a result, these otherwise intelligent and sensitive people become withdrawn and isolated.
When in contact with a person who stammers:
• Try not to show your embarrassment or look away. Do not reassure them just wait patiently and they will complete what they want to say
• Do not try to complete their sentences for them
• Maintain eye contact
• Many of those who stammer find answering the phone an ordeal. So if the phone rings and there is silence, wait till the person is able to speak.
Stammering is not due to tongue-tie, so surgery does not help. Since it is aggravated by stress, and the affected individuals appear distressed, antiaxiolytic medications like alpraxolam and valium, tranquillisers and antidepressants were initially tried. But they were not very useful. In short, there is no magic pill to cure stammering.
If a child’s stammer lasts more than six months, causes psychological problems in school, or continues beyond the age of five, it needs to be evaluated.
Children cannot voluntarily control stammering. Ridicule, asking him or her to speak slowly, or forcing him or her to repeat the words wont help. The only way parents can help is by providing a relaxed and supportive environment where the child is allowed to speak without feeling self-conscious.
Speech therapists can work with people who stammer, and by using a variety of techniques, can improve the speech. They can also help improve communication skills and create self awareness and confidence. Newer auditory feedback devices and computer assisted speech training can also be tried out. Many people do not have access to speech therapists and are forced to handle their child’s stammering as best they can.
A person may stammer while talking but not while singing. Asking him or her to formulate thoughts in the mind and then speak in a singsong way often helps. Speaking slowly, syllable by syllable instead of complete words, gets rid of the repetitive “th th th” sounds. Asking the person to follow the speech of the therapist or parent also helps. Sometimes using a gesture as the stammer sets in takes the concentration away from the speech and the stammer disappears.
Universal tips
• Sing the words
• Visualise the words in your head first
• Take a deep breath before speaking
• Speak slowly and break up the words into smaller components
• Speaking loudly or in a whisper makes stammering less obvious
If your child stammers, encourage him or her to do physical activity. This gives confidence which helps the anxiety and depression caused by stammering. Yoga calms the mind and corrects faulty breathing. It also improves speech in those who stammer.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Tuesday, March 9, 2010
i can't breathe
Hunger for air
YOUR HEALTH
DR GITA MATHAI
“I can’t breathe,” said the woman, panic stricken and one hand clutched at her chest. Her forehead was lined with sweat and fear of death etched on her face. Breathing, after all, is essential for life.
We take breathing or respiration for granted. It is an involuntary, autonomous and automatic reflex that is present from birth to death. We can consciously take deep or shallow breaths, but we cannot stop breathing at will. In short, you cannot commit suicide by voluntarily ceasing to breathe.
Breathing difficulty is a perception. Some people may have fairly severe lung restriction, but be able to continue their normal activities. Others may feel breathless with the slightest unaccustomed exertion. This is more likely to occur if the person is unfit, obese and unaccustomed to exercise. A sudden “panic attack” owing to an external factor can be “breath stopping”. High altitudes and high temperature can also cause similar problems.
Breathing difficulty can occur suddenly because of a foreign body like a peanut which has got lodged in the food pipe. This then becomes a medical emergency. Immediately stand behind the person, make a fist with both hands and exert a sudden forceful upward thrust in the stomach area below the chest bone (sternum). This is called a “Heimlich maneuver” and it has saved many lives.
Mucous secretions — watery in case of viral infections and allergy, and thick and viscous in case of secondary bacterial infection — can clog the nasal passages and bronchi. Some of these secretions can drip backwards into the throat, causing a post nasal drip with a sense of suffocation.
The nasal passages can be cleared with nose drops. It is important to use saline nasal drops. This is commercially manufactured by many companies. It needs to be used every two hours. Nasal drops containing chemicals may provide faster relief. But as the effect wears off, they may cause “rebound congestion” with worse blockage. Long-term frequent usage of chemical nose drops may cause habituation, wherein the body stops responding to the medication. If the nasal block is due to an allergy, prescribed locally acting steroid nasal sprays are very effective.
The bronchi can narrow in response to exposure to ingested allergens like peanuts and food colour, or inhaled ones like cigarette or wood smoke, room fresheners and mosquito repellents. This is called reactive airways disease or asthma.
Smokers may have damaged their lungs structure permanently, causing a disease called COAD (chronic obstructive airways disease). This sets in around 20-30 years after the first puff. It attacks people in their 40s and 50s. They become breathless with exertion and sometimes even at rest. Some require continuous artificial oxygen supply.
Initially — that is, before damage sets in — airway constriction is reversible. Inhalers or rotahalers deliver relief producing bronchodilating medication directly to the bronchi. The respite is immediate and sustained if the medication is “puffed” as prescribed. Direct delivery systems make medication more effective and are less likely to cause side effects.
The rate of breathing increases during pregnancy because of the oxygen demand of the baby. Moreover, pregnancy causes the uterus to enlarge which pushes the abdominal contents upwards. This may cause a feeling of inadequacy while breathing. This is self-limited and disappears with delivery.
Congenital heart disease, heart failure and myocarditis (disease of the heart muscles) can cause difficulty in breathing and a feeling of air hunger. This is because a failing heart provides inefficient circulation of blood and insufficient oxygenation to the tissues of the body. The blood carrying capacity of the body itself may be compromised because of anaemia. Specific medication for the diseases will help with the problem.
Breathlessness needs to be evaluated if:
The difficulty occurred suddenly for no apparent reason
• It was accompanied by chest discomfort, pain or pressure
• It comes with a slight exertion or at rest
• There is an inability to lie down flat and sleep
• It is accompanied by fever
• There is pressure, fullness or a squeezing pain in the chest.
Good breathing techniques require the co-ordinated use of intercostals (groups of muscles that run between the ribs, and help form and move the chest wall), diaphragm and stomach muscles. As the breath goes in, the intercostals and stomach expand and the latter moves outwards. And as we breathe out, the chest contracts, the diaphragm moves up and the stomach moves in. Breathing is a natural response and occurs normally and naturally in children. As age advances, we tend to lose the ability to breathe efficiently.
Long hours at work seated in a sloppy posture, obesity or an inactive life without the mandatory one hour of aerobic activity (running, swimming, jogging or cycling) results in inefficient and inadequate breathing, even in a normal individual.
Place a hand on your abdomen, stand in front of a mirror and breathe in and out to check if your breathing is correct. Consciously correct deficiencies and practise breathing exercises (yoga pranayam) for a healthier tomorrow.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
YOUR HEALTH
DR GITA MATHAI
“I can’t breathe,” said the woman, panic stricken and one hand clutched at her chest. Her forehead was lined with sweat and fear of death etched on her face. Breathing, after all, is essential for life.
We take breathing or respiration for granted. It is an involuntary, autonomous and automatic reflex that is present from birth to death. We can consciously take deep or shallow breaths, but we cannot stop breathing at will. In short, you cannot commit suicide by voluntarily ceasing to breathe.
Breathing difficulty is a perception. Some people may have fairly severe lung restriction, but be able to continue their normal activities. Others may feel breathless with the slightest unaccustomed exertion. This is more likely to occur if the person is unfit, obese and unaccustomed to exercise. A sudden “panic attack” owing to an external factor can be “breath stopping”. High altitudes and high temperature can also cause similar problems.
Breathing difficulty can occur suddenly because of a foreign body like a peanut which has got lodged in the food pipe. This then becomes a medical emergency. Immediately stand behind the person, make a fist with both hands and exert a sudden forceful upward thrust in the stomach area below the chest bone (sternum). This is called a “Heimlich maneuver” and it has saved many lives.
Mucous secretions — watery in case of viral infections and allergy, and thick and viscous in case of secondary bacterial infection — can clog the nasal passages and bronchi. Some of these secretions can drip backwards into the throat, causing a post nasal drip with a sense of suffocation.
The nasal passages can be cleared with nose drops. It is important to use saline nasal drops. This is commercially manufactured by many companies. It needs to be used every two hours. Nasal drops containing chemicals may provide faster relief. But as the effect wears off, they may cause “rebound congestion” with worse blockage. Long-term frequent usage of chemical nose drops may cause habituation, wherein the body stops responding to the medication. If the nasal block is due to an allergy, prescribed locally acting steroid nasal sprays are very effective.
The bronchi can narrow in response to exposure to ingested allergens like peanuts and food colour, or inhaled ones like cigarette or wood smoke, room fresheners and mosquito repellents. This is called reactive airways disease or asthma.
Smokers may have damaged their lungs structure permanently, causing a disease called COAD (chronic obstructive airways disease). This sets in around 20-30 years after the first puff. It attacks people in their 40s and 50s. They become breathless with exertion and sometimes even at rest. Some require continuous artificial oxygen supply.
Initially — that is, before damage sets in — airway constriction is reversible. Inhalers or rotahalers deliver relief producing bronchodilating medication directly to the bronchi. The respite is immediate and sustained if the medication is “puffed” as prescribed. Direct delivery systems make medication more effective and are less likely to cause side effects.
The rate of breathing increases during pregnancy because of the oxygen demand of the baby. Moreover, pregnancy causes the uterus to enlarge which pushes the abdominal contents upwards. This may cause a feeling of inadequacy while breathing. This is self-limited and disappears with delivery.
Congenital heart disease, heart failure and myocarditis (disease of the heart muscles) can cause difficulty in breathing and a feeling of air hunger. This is because a failing heart provides inefficient circulation of blood and insufficient oxygenation to the tissues of the body. The blood carrying capacity of the body itself may be compromised because of anaemia. Specific medication for the diseases will help with the problem.
Breathlessness needs to be evaluated if:
The difficulty occurred suddenly for no apparent reason
• It was accompanied by chest discomfort, pain or pressure
• It comes with a slight exertion or at rest
• There is an inability to lie down flat and sleep
• It is accompanied by fever
• There is pressure, fullness or a squeezing pain in the chest.
Good breathing techniques require the co-ordinated use of intercostals (groups of muscles that run between the ribs, and help form and move the chest wall), diaphragm and stomach muscles. As the breath goes in, the intercostals and stomach expand and the latter moves outwards. And as we breathe out, the chest contracts, the diaphragm moves up and the stomach moves in. Breathing is a natural response and occurs normally and naturally in children. As age advances, we tend to lose the ability to breathe efficiently.
Long hours at work seated in a sloppy posture, obesity or an inactive life without the mandatory one hour of aerobic activity (running, swimming, jogging or cycling) results in inefficient and inadequate breathing, even in a normal individual.
Place a hand on your abdomen, stand in front of a mirror and breathe in and out to check if your breathing is correct. Consciously correct deficiencies and practise breathing exercises (yoga pranayam) for a healthier tomorrow.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
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